Credentialing Specialist (US Healthcare) | Get a 21K Signing Bonus
Posted about 1 month ago
ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced Healthcare Customer Service Representative to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!
Account specific roles and responsibilities:
- Process initial credentialing, recredentialing, and payer enrollment applications for healthcare facilities and providers
- Coordinate with insurance companies, managed care organizations, Medicare, Medicaid, and commercial payers regarding credentialing requirements and application status
- Maintain accurate provider and facility records within credentialing databases and tracking systems
- Gather, verify, and organize required credentialing documentation such as licenses, certifications, malpractice insurance, W-9s, NPIs, and CAQH profiles
- Conduct regular follow-up with payers to ensure timely processing and approval of applications
- Monitor credentialing expiration dates and support timely renewals and revalidations
- Update and maintain CAQH profiles and payer portals
- Review applications for completeness and accuracy prior to submission
- Communicate credentialing status updates to internal stakeholders and clients
- Assist in resolving credentialing-related issues, denials, or discrepancies
- Ensure compliance with payer requirements, company policies, HIPAA regulations, and credentialing standards
- Generate reports and maintain credentialing trackers as needed
Requirements
- At least 1 year of experience in US healthcare credentialing, provider enrollment, or insurance verification
- Experience handling facility credentialing and payer enrollment processes preferred
- Familiarity with Medicare, Medicaid, commercial insurance payers, and MCO credentialing processes
- Knowledge of CAQH, NPI, PECOS, and payer portals preferred
- Strong attention to detail and organizational skills
- Excellent written and verbal communication skills
- Ability to manage multiple applications and deadlines simultaneously
- Proficient in Microsoft Office tools, particularly Excel and Outlook
- Must be willing to work on-site in Shaw Blvd, Mandaluyong
- Amenable working night shifts
Benefits
What Can We Offer You?
- Competitive salary and benefits
- Health Insurance with free dependents*
- 10%-night differential
- Attendance Bonus
- Paid Time Off
- Convertible to cash leave credits
- Performance Appraisal
- Work-life balance
- A focus on growing your career path with us
- We encourage you to follow your passions and learn new skills
Our Commitment to You
- Strong culture and values-driven leadership
- We create opportunities for you to learn and grow at any stage of your career
- Continuous learning and innovation
- We foster an all-inclusive environment where everyone thrives
Other open roles at ISTA Personnel Solutions(6)
Welcome to ISTA Solutions, your go-to remote staffing solutions provider. We understand the challenges businesses face when managing their workflows and finding the right people to execute their vision. That's why we exist—to be your dedicated partner in growth. Here are some reasons why our services are a must-have for your business: -We provide tailor-made workflow solutions that cater to your unique business requirements, helping you streamline your operations, reduce the turnaround time, and maximize efficiency. -Our agents are skilled, experienced, and solely focused on your company. They are trained to deliver outstanding results while working closely with your team and adhering to your company's culture. -We leverage our global resources to provide comprehensive support for your business, including technical assistance, billing services, and recruitment. This way, you can focus on growing your business while we take care of the back-end operations. At ISTA Solutions, we believe in the power of building strong relationships with our clients. We strive to be your long-term partner in success, providing ongoing support and guidance to help you navigate through any challenges that may arise. We understand the importance of transparency and honesty in business. That's why we pride ourselves on being open, ethical, and straightforward in all our client interactions. Without ISTA, healthcare companies commonly face: -Overburdened workforce -Increased demand for productivity -The need to reduce operational costs -The lack of specialized expertise in-house -Difficulty finding reliable remote staff We know that these problems can have a big effect on the growth and success of your business, which is why we're here to offer you complete remote staffing solutions. Whether you need customer service support, technical assistance, or a team of virtual assistants, we have the expertise to help you achieve your business goals.
Key team members
Nicole Barrish
DJ Narvaez RN
Cindy Mojela
Carmin Myburgh
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